Abstract | BACKGROUND AND AIMS: Increased sodium intake is associated with increased risk of decompensation in patients with heart failure. This non-randomized, open-label, controlled study aimed to examine the feasibility, preliminary safety and efficacy of a low sodium- potassium enriched salt substitute compared to regular table salt in patients with heart failure with reduced ejection fraction (HFREF). METHODS: Fifty patients (68% male, NYHA I/II/III 6%/68%/26%, mean age 70 ± 9 years, LVEF 31 ± 5%, median BNP 112 pg/ml) were included. Of these, 30 patients received the salt substitute (maximum consumption of 2 g daily), who were prospectively compared to a control group of 20 age/sex/NYHA class-matched HFREF patients who consumed regular salt (maximum consumption of 2 g daily). Consumption of regular salt was prohibited in the salt substitution group. All patients were followed for 12 weeks. RESULTS: Patient groups did not differ by sex, age, LVEF, NYHA class, 6MWD, and BNP at baseline. In primary safety analysis, no significant differences were detected between groups regarding SBP (p = 0.052), DBP (p = 0.159), HR (p = 0.246), serum potassium (p = 0.579), serum sodium (p = 0.125), and eGFR (p = 0.710) throughout the 12 weeks. Secondary efficacy analysis revealed a statistically significant difference in 6MWD at 12 weeks between the salt substitute and regular salt groups after adjustment for baseline 6MWD (mean difference±SEM, 4.7 ± 2.1 m, F = 4.92, p = 0.031). CONCLUSIONS: In this pilot study, a low sodium- potassium enriched salt substitute was found to be safe compared to regular salt in HFREF patients, while it resulted in a small albeit significant improvement in exercise capacity, possibly justifying further investigation with randomized clinical studies.
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Authors | Vasiliki Bistola, Angelos Arfaras-Melainis, Efstratios Trogkanis, Georgios Bakosis, Eftihia Polyzogopoulou, Ioannis-Nektarios Karavidas, Ignatios Ikonomidis, John Parissis, Apostolos Karavidas |
Journal | Clinical nutrition ESPEN
(Clin Nutr ESPEN)
Vol. 35
Pg. 90-94
(02 2020)
ISSN: 2405-4577 [Electronic] England |
PMID | 31987127
(Publication Type: Journal Article)
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Copyright | Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
- Potassium, Dietary
- Sodium Chloride, Dietary
- Sodium
- Potassium
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Topics |
- Aged
- Diet, Sodium-Restricted
- Exercise
- Female
- Glomerular Filtration Rate
- Heart Failure
(diet therapy)
- Humans
- Male
- Middle Aged
- Non-Randomized Controlled Trials as Topic
- Pilot Projects
- Potassium
(blood)
- Potassium, Dietary
(administration & dosage, analysis)
- Prospective Studies
- Sodium
(blood)
- Sodium Chloride, Dietary
(administration & dosage, analysis)
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